Screening Experts to Talk About Rationale Behind Different Guidelines for Breast Cancer Screening

Physicians who have played a role in developing screening guidelines will share their thoughts on breast cancer screening recommendations for average-risk women.

The John and Marney Mathers Lecture, “USPSTF Task Force Guidelines for Breast Cancer Screening,” takes place from 8:10 – 9 am today in Hall D. George Sawaya, MD, professor in obstetrics, gynecology and reproductive sciences and epidemiology & biostatistics at the University of California, San Francisco, will argue for the U.S. Preventive Services Task Force (USPSTF)Screening recommendation to screen every two years. Mark Pearlman, MD, S. Jan Behrman professor in Reproductive Medicine in the department of obstetrics/gynecology and professor of surgery with the University of Michigan Hospital and Health Systems in Ann Arbor, supports annual breast cancer screening.

Breast cancer screening guidelines remain a hot topic in medicine, because breast cancer is the most common type of cancer in women, with about 1 in 8 women developing the disease in their lifetime. It’s also the leading cause of premature death among all cancers in the United States, with nearly three times as many breast cancer deaths as all gynecological cancers combined.

George Sawaya, MD

Mark Pearlman, MD

Dr. Sawaya, a member of the USPSTF from 2004-08, wants to give the audience a look at how the Task Force uses its collective judgment to develop screening guidelines. He will share evidence about the actual numbers used to come up with the guidelines and let the audience consider whether a line should be drawn or if it should all be put before patients.

“It’s not just opinions from experts sitting around the table in a kind of top-down approach,” he said. “It’s more of a bottom-up approach, trying to understand what the real evidence is — not just the benefits but also harms — and making that difficult judgment about the balance of benefits and harms and how that transforms into a recommendation.”

Dr. Pearlman was the senior author on the ACOG Practice Bulletin in 2009 that called for annual mammograms beginning at age 40, as well as the revised ACOG guidelines scheduled to be released this year. He also helped write the guidelines published by the National Comprehensive Cancer Network, which align with ACOG’s guidelines.

Dr. Pearlman said that those who attend today’s lecture will benefit from learning the scientific basis behind guidelines. They will be better able to provide informed, quality guidance to their patients about when to start getting screened and how frequently they should be screened.

“It is incumbent on ACOG members to understand the reasons for the different recommendations and to be able to share that information with their patients. Members should be able to help their patients, based on their values and principles, determine what they should be doing in terms of average-risk mammography screening,” he said.